Quality of life in survivors after cervical artery dissection

Fischer, Urs; Ledermann, Irene; Nedeltchev, Krassen; Meier, Niklaus; Gralla, Jan; Sturzenegger, Matthias; Mattle, Heinrich P; Arnold, Marcel (2009). Quality of life in survivors after cervical artery dissection. Journal of neurology, 256(3), pp. 443-9. Heidelberg: Steinkopff-Verlag 10.1007/s00415-009-0112-2

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BACKGROUND AND PURPOSE: Little data exists about longterm outcome, quality of life (QOL) and its predictors after spontaneous cervical artery dissections (sCAD). METHODS: Clinical and radiological data of 114 patients with sCAD were collected prospectively. Six patients died within 3 months, the remaining 108 were contacted after a mean of 1498 days (range: 379-3455), 99 survivors (92 %) replied. QOL, assessed with the stroke-specific QOL scale (SSQOL), and functional abilities, measured with modified Rankin Scale (mRS) were compared, and predictors of QOL were analyzed. Subgroup analyses were performed for patients with ischemic stroke, those with isolated local symptoms or transient ischemic symptoms and those without significant disabilities (mRS 0-1) at follow-up. RESULTS: Seventy-one of 99 patients (72 %) had no significant disability, but only 53 (54 %) reported a good QOL (SS-QOL > or = 4). Compared to the self-rated premorbid QOL of all patients, SS-QOL was impaired after sCAD (p < 0.001); impairment of QOL was observed in patients with ischemic stroke (p < 0.001), in patients with isolated local or transient ischemic symptoms (p < 0.038) and those without significant disabilities at follow-up (p = 0.013). Nevertheless, low mRS was associated with better overall QOL (Kendall's tau > 0.5). High National Institute of Health Stroke Scale score on admission and higher age were independent predictors of impaired QOL (p < 0.05). CONCLUSION: QOL is impaired in almost half of long-term survivors after sCAD, even in patients with local or transient symptoms or without functional disability. Impairment of QOL is a surprisingly frequent long-term sequela after sCAD and deserves attention as an outcome measure in these patients.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Head Organs and Neurology (DKNS) > Clinic of Neurology
04 Faculty of Medicine > Department of Radiology, Neuroradiology and Nuclear Medicine (DRNN) > Institute of Diagnostic and Interventional Neuroradiology

UniBE Contributor:

Fischer, Urs; Nedeltchev, Krassen; Meier, Niklaus; Gralla, Jan; Sturzenegger, Matthias; Mattle, Heinrich and Arnold, Marcel

Subjects:

600 Technology > 610 Medicine & health

ISSN:

0340-5354

ISBN:

19319463

Publisher:

Steinkopff-Verlag

Language:

English

Submitter:

Factscience Import

Date Deposited:

04 Oct 2013 15:05

Last Modified:

26 Jun 2018 14:07

Publisher DOI:

10.1007/s00415-009-0112-2

PubMed ID:

19319463

Web of Science ID:

000265732800019

BORIS DOI:

10.7892/boris.28426

URI:

https://boris.unibe.ch/id/eprint/28426 (FactScience: 120712)

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